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Changes in Mammary Gland Morphology and Breast Cancer Risk in Rats
Published on: October 16, 2010
Underlying pathology in mammary Paget's disease
J H Yim1, M R Wick, G W Philpott
1Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Annals of Surgical Oncology
|June 1, 1997
Summary
Mammary Paget's disease often involves underlying multifocal breast cancer, even when not palpable or visible on mammography. Careful evaluation is crucial for effective treatment planning.
Area of Science:
- Oncology
- Breast Surgery
- Radiology
Background:
- Management of mammary Paget's disease lacks consensus, with treatment options varying from radiotherapy to mastectomy.
- This review aims to correlate breast findings with disease stage and patient outcomes.
Purpose of the Study:
- To guide the evaluation and treatment of mammary Paget's disease by analyzing associated breast findings.
- To understand the relationship between clinical presentation, imaging, and histopathology in Paget's disease.
Main Methods:
- Retrospective review of clinical, mammographic, and pathological data from 38 patients treated between 1979 and 1995.
- Histopathological evaluation of breast tissue and lymph nodes for carcinoma in patients undergoing mastectomy.
Main Results:
- Underlying breast carcinoma (in situ or invasive) was detected in 92% of patients, often multifocal (73%).
- Mammography had limited sensitivity in detecting underlying disease, especially in non-palpable, multifocal cases (64% failure rate).
- Palpable masses correlated with higher rates of invasive cancer, multifocal disease, lymph node involvement, and poorer survival.
Conclusions:
- Mammary Paget's disease frequently presents with occult, multifocal carcinoma, including invasive types.
- Breast conservation therapy may be suitable for select cases, but identifying these patients is challenging due to inapparent disease.
- Mastectomy remains a consideration due to the high prevalence of extensive underlying malignancy.
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